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Behavior Therapy Plan Adjustment by Provider

Illinois rates for HCPCS 97155

This service is a hands-on session where a qualified provider directly works with a patient, most often a child with autism, to observe how a behavior support plan is going and make adjustments in real time. It differs from sessions run by a trained technician because the treating provider is personally present and actively modifying the approach based on what they see.

Rates data updated July 2026.

Facilitymedian $19 · 10th–90th $19$1950%50%90th$19Professionalmedian $21 · 10th–90th $19$360%20%40%10th90th$21$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$194.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$19.05
Typical High
$25.12
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.91
Typical High
$24.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$36.31
Typical High
$36.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$33.88
Typical High
$52.48
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$44.67
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$39.81
United
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$125.89
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$41.69
Typical High
$66.07